A survey of epidural analgesia for labour in the United Kingdom

A postal survey of obstetric units throughout the UK was conducted to obtain information about the provision of epidural analgesia for labour. Ninety per cent of units offered a 24-h epidural service and the average epidural rate was 24%. The most commonly administered epidural test dose was 3 ml of bupivacaine 0.5% and bupivacaine 0.25% was most often used as the initial epidural top-up. Continuous infusions of low-dose bupivacaine and opioid mixtures were the most popular method of maintenance epidural analgesia. Twenty-four per cent of units offered combined spinal-epidural analgesia in addition to standard epidural analgesia. Midwives played a prominent role in the administration of epidural bolus top-ups and also in the assessment and maintenance of continuous epidural infusions.